Evidence map›Paper›PMID 40905901›Full record

ArticleAnnals of emergency medicine2026

Feasibility of Pediatric Diagnostic Quality Measurement in All United States Hospitals.

Kenneth A Michelson, Joseph A Grubenhoff

Abstract read
In one paragraph

Article in Annals of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Kenneth A MichelsonDivision of Emergency Medicine, Ann & Robert Lurie Children's Hospital, Chicago, IL. Electronic address: kenmichelson@luriechildrens.org.
Joseph A GrubenhoffSection of Pediatric Emergency Medicine, University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO.

Funding

Measuring and Mapping National Pediatric Acute Care OutcomesR01HD112321 · NICHD · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI Kenneth Michelson · 2023 to 2026
$1.6M
AHRQ HHS K08 HS026503NICHD NIH HHS R01 HD112321
6 · The paper itself

Abstract

STUDY

objectiveTo evaluate the proportion of emergency departments (EDs) with sufficient volumes to measure pediatric misdiagnosis reliably.

methodsWe conducted a cross-sectional study of a nationally representative 20% sample of US EDs within the 2022 Nationwide Emergency Department Sample. We counted the number of child visits (less than 18 years old) at each ED for each of 24 serious pediatric emergency conditions and each ED's total across all conditions. We calculated the proportion of EDs that could reliably measure misdiagnosis rates at least 10% worse than condition-specific national reference standards. We also calculated the proportion of children visiting measurable EDs.

resultsReliable misdiagnosis measurement across all serious conditions was possible in 614 out of 4,515 EDs (13.6%, 95% confidence interval [CI] 11.5 to 15.9). Appendicitis was the most reliably measurable condition (n=530 EDs, 11.7%, 95% CI 9.8 to 14.0), whereas complicated pneumonia (n=33, 0.7%, 95% CI 0.3 to 1.5), testicular torsion (n=29, 0.6%, 95% CI 0.2-1.4), and intussusception (n=25, 0.6%, 95% CI 0.2 to 1.2) were less frequently measurable. The 20 other included conditions were not reliably measurable in any ED (0.0%, 95% CI 0.0 to 0.4). Midwest, nonmetropolitan, and EDs evaluating less than 1,800 children per year were least likely to be able to support reliable measurement. Among 185,490 children with a serious condition, 130,894 (70.6%) visited an ED in which misdiagnosis was measurable.

conclusionFew EDs have sufficient pediatric volumes to reliably measure diagnostic accuracy generally, and even fewer can do so for individual conditions. Aggregation of EDs could improve power to measure misdiagnosis.

Indexed as

Diagnostic ErrorsEmergency Service, HospitalAdolescentChildChild, PreschoolCross-Sectional StudiesFeasibility StudiesFemaleHumansInfantMaleUnited StatesDiagnostic errorDiagnostic qualityPediatric emergency medicinePediatric readinessPediatric safety

Identifiers

PMID40905901
PMCPMC12412902

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.